Antibiotics-loaded Nanofibers Fabricated by Electrospinning for the Treatment of Bone Infections

Electrospinning is one of the most promising fabrication techniques of nanostructured membranes for guided bone regeneration. In association with antibiotics, membranes consisting of fibers with sub-micrometric and nanometric dimensions have been tested to prevent and treat bone infections. Electrospinning was recently applied to produce metallic implant coatings for biofilm inhibition. Despite the numerous in vitro and in vivo studies conducted with nanofibers from several polymeric matrices and fabrication methods, there is no consensus on the best conditions to optimize their antimicrobial activity. This study analyzed recent advances in nanofiber fabrication by the electrospinning technique for clinical applications in the treatment of bone infections. An integrative review from MEDLINE/PubMed, Web of Science, and Scielo databases selected 16 works focused on nanofibers' in vitro and in vivo evaluations. It was found that manufacturing methods significantly influence fiber composition, structure, morphology, pore size, and biodegradability. Thus, standardizing these parameters in the production of nanofibers at an industrial scale is one of the challenges in improving drug loading control on the fiber network and its release profiles. Further in vivo studies need to be conducted to optimize the dose effect of antibiotic-loaded membranes in inhibiting the proliferation of pathogens and inflammatory processes without promoting toxicity and reducing bone regenerating capacity.